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J F Colombel

Publications and source records attributed to J F Colombel.

268 records · Page 15Linked to original sources
PubMedDate not supplied

[Peroxisome proliferator-activated receptor (PPAR) gamma: a new target for the treatment of inflammatory bowel disease].

UNLABELLED: The peroxisome proliferator-activated receptor (PPAR) gamma is highly expressed in the colon mucosa. In vitro, it regulates inflammation. AIM: To evaluate the anti-inflammatory functions of PPARgamma agonist during a trinitrobenzene sulfonic acid (TNBS)-induced colitis in mice. METHODS: Colitis was induced in Balb/c mice after intra-rectal administration of TNBS. The intensity of inflammation was assessed 2 and 5 days after colitis induction by macroscopic and histologic scores and by the quantification of colon myeloperoxidase (MPO), IL-1B and TNFalpha mRNA concentrations. The therapeutic role of PPARgamma agonist given by oral gavage was assessed in preventive and treatment modes. RESULTS: TNBS induced severe macroscopic and histologic lesions, with high mucosal MPO, IL-1B and TNFalpha mRNA concentrations. PPARgamma agonist given preventively or in treatment mode allowed a significant decrease of macroscopic and histologic scores through a normalization of MPO, IL-1B and TNFalpha mRNA concentrations. CONCLUSION: PPARgamma agonist decreases the intensity of TNBS induced colitis through normalization of IL-1B and TNFalpha expression. PPARgamma agonists may be proposed as new therapeutic agents in inflammatory bowel diseases.

Animals↗
PubMedDate not supplied

Chronic cholestasis and macronutrient excess in patients treated with prolonged parenteral nutrition.

The mechanism of chronic cholestasis observed during prolonged parenteral nutrition remains unclear. We studied liver function tests in 18 consecutive gastroenterological adult patients submitted to 18 mo (median; range 6-66 mo) of parenteral nutrition. Seven patients (group B) developed a cholestatic nonobstructive jaundice, culminating after 3 mo, (1-4 mo) whereas 11 patients (group A) did not develop chronic abnormalities on liver function tests during parenteral nutrition. Liver biopsies obtained at 4 mo (3-6 mo) in 6 group B patients demonstrated bile duct proliferation in the portal area, with extensive fibrosis, cholestasis, and focal necrosis of hepatocytes. Initial intakes of calories, fat, and protein were higher (p less than 0.01) in group B than in group A patients and, when reduced, were associated with reversal of jaundice and improvement in liver function tests and histological findings. These data suggest that the development and course of cholestasis are influenced by excess parenteral intake of protein and mixed-energy sources.

Adult↗
PubMedDate not supplied

Serological aspects of coeliac disease.

We have evaluated the sensitivity and specificity of serum anti-gliadin, anti-reticulin and anti-endomysium antibody determinations for the diagnosis of coeliac disease. Serum samples from 54 children and 9 adults with untreated coeliac disease were analysed for anti-gliadin antibodies and compared to the results obtained for 111 non coeliac controls (72 children, 39 adults) and 221 healthy blood donors. This yields sensitivities of 87% and 86% for IgA and IgG antibodies. Specificities were respectively of 95.5% and 91%. Anti-reticulin and anti-endomysium IgA were analysed in a more limited number of sera. Specificity of both tests was of 100% for the IgA class of antibody. However sensitivity was only of 64% for anti-reticulin IgA but was of 100% for anti-endomysium IgA. These results indicate that combination of anti-gliadin antibodies (IgA and IgG), anti-reticulin and anti-endomysium IgA may be recommended as screening tests to better select patients suspected of coeliac disease for jejunal biopsy.

Adolescent↗
PubMedDate not supplied

[Is jaundice a cause of error in the interpretation of CA 19-9 blood levels?].

Serum CA 19-9 has been proposed as a tumour marker for pancreatic cancer (PC). However, false positive results are seen in sera of patients with benign jaundice. The CA 19-9 assay was performed by a solid state radioimmunoassay in 86 icteric patients (total bilirubin greater than 2 mg/dl). 24/86 had PC (12 men, 12 women, mean age 74 years) and 62/86 had benign jaundice (29 men, 33 women, mean age 56 years; cirrhosis: n = 20, angiocholitis: n = 21, hepatitis: n = 21). At a cut-off level of 60 U./ml, for detecting icteric PC, sensitivity was 83%, and specificity was 79%. At 120 U./ml, sensitivity was 79%, but specificity was increased to 92%. We conclude that 21% of patients with benign jaundice had a CA 19-9 level greater than 60 U./ml, and using a CA 19-9 level of 120 U./ml, the specificity of the test to detect icteric PC was increased, with little decrease in the sensitivity.

Aged↗
PubMedDate not supplied

Familial Crohn's disease in multiple siblings: no linkage to the HLA system.

We report five families with 3 or more children having Crohn's disease. In one family, 6 out of 11 siblings were affected. HLA haplotype study in affected children showed that the probability of random segregation was only 38 percent, making improbable a linkage between the histocompatibility locus and the development of Crohn's disease. However similar clinical patterns in siblings could suggest a genetic factor not linked to the HLA system.

Adolescent↗
PubMedDate not supplied

Long-term follow-up of strictureplasty in Crohn's disease.

Strictureplasty is an alternative to extensive and/or multiple small bowel resections in the surgical treatment of Crohn's disease. We here report a series of 22 patients (12 M-10 F-mean age years 28). All patients had non perforative form of Crohn's disease lasting for a mean of 8 years. Nine out of 22 had previous intestinal resections. A total of 201 stenosis was identified during per-operative examination (mean per patient: 9). Only tight stenoses (diameter < 2 cm) were treated while others were left untouched. Eighty-three stenoses were treated by short strictureplasty and 24 by long strictureplasty using steel thread. One or several resections were simultaneous performed in 15 patients. Mortality was nil. A post operative abscess without loosened suture was drained. The mean follow-up in the 22 patients was 36 months (range: 12 to 96). Relief of obstructive symptoms was achieved in all patients. Symptomatic recurrence occurred in 9 patients (40%) and 5 (22%) needed reoperation. In one case haemorrhagic ulceration developed within a long strictureplasty and in 4 others stenosis developed in plasty areas but also in previous healthy areas. Thus stricture-plasty is intended not to replace resection but rather to serve as a useful adjunct to the existing surgical options in the treatment of Crohn's disease, especially when short bowel syndrome is a consideration.

Adolescent↗
PubMedDate not supplied

[Indications of surgical treatment of Crohn disease].

Indications for surgery in Crohn's disease were studied in 100 consecutive cases. Cases included emergency situations (n = 22) complicated forms (n = 55) and chronic forms (n = 23). Lesions were located in the small bowel alone (n = 43), small and large bowel (n = 16) and in the colon and rectum (n = 16). During the same period, 26 reoperations were performed, there was no operative mortality and no short bowels were observed. A stomy was required in 30 cases and could be removed in 19. For lesions involving the small bowel, resections were limited to symptomatic lesions; long and short plasties were performed with no complications. For the colon, total and segmentary colectomy was performed for 18 cases and ileorectal anastomoses in 13. Five proctectomies were required. Rectal exclusion was considered as a wait and see solution which was long in several cases with severe rectoperineal lesions. In these cases, secondary proctectomy should be widely proposed. For emergency situations, it would be prudent to use a safe operative technique with wide indication for stomies. For complicated forms, careful preparation allows for complete procedure with one operation. For chronic forms resistant to medical treatment, the decision can be rather difficult, but the fact that recurrences do exist should not mask the long-term remissions obtained in half the cases with surgery.

Chronic Disease↗
PubMedDate not supplied

[Chronic interstitial nephritis and mesalazine: 3 new cases?].

We report three new cases of chronic interstitial nephritis occurring in two patients with Crohn's disease and one patient with ulcerative colitis treated with mesalazine. In the three cases asymptomatic renal disease was revealed by an increase in serum creatinine which was normal before treatment. Renal biopsy showed features of severe chronic interstitial nephritis. Mesalazine withdrawal and administration of steroids in two cases led to partial improvement of renal function. Mechanism of renal toxicity of mesalazine is unknown. These observations stress the need for monitoring renal function in patients with inflammatory bowel disease treated with mesalazine.

Adult↗